Scabies
Everyone cringes at the mention of them. Unfortunately, most people will encounter scabies sometime in their life. Scabies is a mite that is spread from person to person by skin to skin contact. Here are a few facts and tips about scabies that should prevent the panic that often ensues when it is mentioned.
FACT #1
Scabies is spread by skin to skin contact only and does not live on inanimate objects. It must have dead skin to feed on to survive. This is why we recommend treating all household contacts only and not necessarily coworkers or acquaintances. This is also why there is no need to have your house fumigated. We recommended weekly hot water washing and drying of towels, bedsheets, and stuffed animals as well as thorough dusting and vacuuming weekly for a month after diagnosis. Without dead skin to live on, mites will not survive more than 2-3 days.
FACT #2
Most people with scabies only have a few (<10) on their whole body. This is why Dr. Rosenberger rarely does a scraping to try to diagnose scabies. It is easy to miss it, and we don’t want to give people a false sense that they are fine if no scabies are found on the scraping. There is a rare variant called crusted Norwegian scabies where an immunocompromised person has thousands of scabies mites.
FACT#3
It can take weeks to feel better even after all the mites are dead. The dead mites and their dead eggs remain in the outer layer of the skin. It may take six weeks or more until symptoms totally resolve until the dead skin and eggs are shed. We recommend using OTC Cerave Itch Relief Cream or Lotion to alleviate symptoms.
FACT#4
Scabies can be treated with topical and oral medications. Dr. Rosenberger prefers to treat with oral medication as much as possible. There are two main problems with the topical FDA approved medications, Eurex and Elimite. First, the topical medication may not be thoroughly applied and is recommended only to be used neck down. What if you have a mite neck up? Second, there is well-known resistance that has developed to topical scabies medications. The oral medication is ivermectin. Ivermectin is taken as a single dose with food and repeated in one to two weeks. Simple and there’s nothing getting by the oral medication. Drug interactions with and allergies to ivermectin are rare. Although ivermectin is not FDA approved to treat scabies, it is extremely effective.
I hope this post helps separate scabies fact from fiction. It is an easily treatable and common skin condition.
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